Parade Magazine's Ad Linking Gastric Banding to Type 2 Control: Opening a Campaign for a New Means of Treating Diabetes?

| Nov 18, 2009

An ad in the November 15, 2009, edition of Parade magazine may be the opening salvo in a campaign to push adjustable gastric bands as a weight loss aid to help overweight type 2s dramatically improve their symptoms or even go into remission.

The ad for the LAP-BAND AP® System from Allergan, Inc., shows a pretty, overweight, young woman saying, "If I lost the weight, maybe I could improve, or even resolve, my type 2 diabetes." The ad text then discusses the product, which is a device that's placed around the upper part of the stomach and slowly inflated to create a sense of fullness that comes on faster and lasts longer than without the band.

By eating less, a patient fitted with the band can lose a large amount of weight without needing to resort to diets or sheer willpower. The benefit for type 2s is that dramatic weight loss often causes diabetic symptoms to lessen or even disappear

The band, which can be placed in an outpatient procedure, has an advantage over gastric bypass surgery in that it doesn't involve cutting and stapling. This means that the band can be removed relatively easily or adjusted post-procedure without intrusive surgery.

The ad is careful to note that even though the pretty young woman is contemplating how the band might help her type 2 diabetes, doctors cannot currently recommend the band solely as a diabetes-specific treatment. Instead, the ad's fine print states, "The LAP-BAND System is indicated for use in weight reduction for severely obese patients with a Body Mass Index (BMI) of at least 40 or a BMI of at least 35 with one or more severe comorbid conditions, or those who are 100 pounds or more over their estimated ideal weight." The "comorbid conditions" cited can include diabetes, which is the "in" that the doctor of an overweight type 2 patient could use to recommend the band.

There are other fine-print warnings that take some of the glow off the procedure. Though it is done on an outpatient basis, insertion of the band is still considered major surgery, with the risks that surgery entails. Weight loss from the band is more gradual than with gastric bypass surgery, and patients fitted with it must still follow certain dietary requirements. Pregnant women or women trying to become pregnant are advised not to consider the procedure, and well as people who use aspirin or other anti-inflammatory oral drugs.

Parade Magazine, a Sunday newspaper supplement with a nationwide circulation of 33 million, attracts a varied viewership with its combination of celebrity gossip and interviews, recipes, health and lifestyle articles, cartoons, and inspirational stories. That in turn draws such mainstream advertisers as General Motors, Honda, Hewlett-Packard, Dell Computers, Campbell's Soup, and Merck & Co., Inc., makers of the type 2 drug Januvia.

Consequently, inserting an ad that links the band insertion procedure with treatment for type 2 diabetes is a big step toward getting three distinct constituencies to begin thinking of gastric bands as a viable therapy: doctors, type 2s, and insurance companies.

A clamor-or at least an advocacy-for such a treatment could also create pressure to "move the goalposts" and amend the required BMI figures downward to accommodate type 2s who are overweight, but not severely so. The current requirement for very high BMI's insures that remissions in patients with diabetes who undergo the procedure are happy incidentals, not the goal.

Previous discussions of gastric bypass surgery and gastric banding have noted that the remission rates among type 2s who've undergone the procedures have been dramatic-up to 92 percent in some studies. But even though the procedures amount to a proven means of dealing with type 2, there is still a lot of ground to cover before doctors or insurance companies will recommend and support them routinely.

For one thing, nobody knows what adverse long-term effects might arise in the wake of the procedures. Also, nobody is quite clear on why banding the upper part of the digestive tract can have such a dramatic effect on diabetes. How are the two related? It's much like how people learned to use willow bark to treat fever and inflammation long before they knew that the bark contained salicylic acid-aspirin. Knowing that something works often comes well before knowing how and why it works.

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Categories: Complementary Therapies, Diabetes, Diabetes, Losing weight, Type 2 Issues, Weight Loss

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Posted by CLeonard1950 on 19 November 2009

I am walking, talking proof that weight loss can help control diabetes. I lost 100 pounds after my husband's sudden death from a heart attack. That was four years ago. It took two years to lose the weight and I have not regained any of the weight. The best news is that I have been off all diabetes medications (after a nineteen year battle) and my most recent A1C reading was 5.7!!! However, I did it the old fashioned way through proper nutrition and walking. Times are tough and I could not afford surgery nor did I want to take the chance of developing complications. I practice "Healthy Lifestyle with a Healthy Wallet" and "Frugal Fitness". At 59, I'm healthier than EVER but everyday I regret that my husband and I did not do this together. His death was my "a-hah" moment and I simply stopped buying the foods that caused my weight problem and subsequent health issues. Good luck everyone. Just do it - with or without lapband.

Posted by Anonymous on 20 November 2009

Type II diabetics who choose, like I have, to take the risk of major surgery should go for a full ENY type, or a DS type if they are super obese over the band for several reasons. The most important reason is that the bypassing of the small intestine makes the latter operations more likely to be successful and with RNY or DS, there is over a 80% remission rate. With the band the remission rate is 40%. The other issue is that Type II is never cured. It is placed in remission. The band, unfortunately, will in most cases eventually need to be removed since it is a foreign body. Once that is done the likelyhood of recurrence of Type II symptoms are great.

For type II's who are not greatly overweight, the upcoming intestinal sleeves are likely a better treatment than the Lap bands are.

In my case I have not been able to go off of Insulin yet, so I am in the 14% of those who don't completely go into remission. However six weeks out from the operation I am taking about 35% of the amount of both Insulins and that is slowly creeping down.

It is worth looking into these procedures when your type II can no longer be controlled with oral medications. But bear in mind the main part of a bypass that is effective in reducing insulin resistance appears to be the bypassing of the small intestine, which the Lap Band does not do.

Posted by Anonymous on 23 November 2009

Congratulations to anyone and everyone who has taken their own health in their hands and done whatever it takes from Vegan diets to Gastric Bypass to get to a healthier place and help their body control blood sugar the way it was meant to.

While I think this article does a good job in addressing one of the main issues with glucose control (obesity) I disagree with the author's last paragraph where he relates gastric banding for diabetes to the early use of willow bark for headaches and inflammation.

In my opinion using willow bark, raw and direct from nature, to treat a headache is far different from opening someone's body to wrap a piece of plastic (made in a factory) around his/her stomach.

It is of course, only an opinion.

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